Antipsychotic Drugs for Anxiety Disorders?

But are you willing to take an antipsychotic drug to make it stop? Some people are and I think this new trend is a slippery slope that could turn into a big problem.

See, a few weeks ago I had to write a paper about the off-label use of antipsychotic medications for school.

Right after I turned it in, like a day after, I ran into this article in the New York Times.

In it professor of psychiatry Dr. Richard Friedman argues that unless you have schizophrenia, bipolar disorder, or severe depression, taking antipsychotics may be a bad idea.

I agree.

First, a little background. Antipsychotic drugs are better known under their brand names such as: Abilify, Seroquel, Haldol, Zyprexa, and a bunch of other names.

In the 1950’s antipsychotics were first used as a postoperative sedative. Over time doctors figured out that they could also be used on psychotic patients to great effect.

Since then a wide array of “second-generation” antipsychotics have been developed to help people cope with psychotic symptoms like hallucinations.

So how the heck did these drugs end up in anxious people? These drugs are powerful sedatives that block serotonin and dopamine reuptake which reduces “overactive” brain activity. In English that means that these drugs are the ultimate “chill pill.”

Plus, it isn’t shady to prescribe medications that aren’t designed to treat what you have. It’s called off-label use. In fact, the FDA says that doctors are free to prescribe medications to treat off-label conditions as long as doctors have a “firm scientific basis” to do so.

The problem is that there are too few studies proving that these powerful drugs are effective in people with anxiety. By effective I mean treating the underlying anxiety versus just making you sleepy. What is known however is that these drugs come with a ton of side effects.

Here are a few:

Antipsychotic Medication Symptoms

Thorazine was a precursor to second generation antipsyhotic drugs.

1. Weight gain

2. High triglycerides

3. Salivation

4. Hand tremor

5. Confusion

6. Mania

7. Irregular heart beat

8. Seizure

9. High cholesterol

10. Death

Does this mean that all people with anxiety problems should stay away from antipsychotic drugs?

I think they should be considered carefully unless folks are crawling out of their skin and nothing else is working.

I’d like to see more studies, more stats, and more information about the risk-benefit ratio of taking such a drug given all the potential side effects.

This is despite the fact that antipsychotics are often prescribed for mood disorders as a low dose augmentation for other medications.

I want to see this happen before these drugs become the new normal for people with anxiety problems. What I don’t want is a bunch of nervous folks losing their ability to function in the world because they couldn’t find a better way to reduce their high anxiety.

I can think of a lot ways to lower anxiety that don’t involve a pill and chronic sleep. I want to encourage you to be more creative than that.

This is especially true because there are already far less potent drugs available to treat high anxiety. Some of the drugs include:

Anti-Anxiety Medications

1. Celexa

2. Zoloft

3. Prozac

4. Paxil

5. BuSpar

6. Klonopin

7. Valium

8. Xanax

9. Librium

10. Ativan

You have options. Every single drug I listed also come with side effects, but most of those include nausea, stomach problems, and dizziness. The reality is that most psychotropic drugs cause side effects. The question is are you willing to put up with potentially severe side effects?

The other issue is that antipsychotics can really knock you down. When they say sedation, they mean sedation. Below you’ll find a video of a guy on Seroquel. He provides a firsthand account of why antipsychotics can be problematic when you have to work for a living.

Do you need to go through life like a zombie to not feel anxious? No, you don’t.

That being said, always do what works for you as long as it’s safe. My concern is that I don’t want anxious folks taking drugs that they don’t understand, need, or cause harm.

I’ve included in this post several links highlighted in blue so you can dig a little deeper. I simply wanted to introduce you to this new prescription trend.

You know, I’ve never been a huge fan of psych meds, however, I understand that they do help many people get better. There is no doubt about it. I just want you to have the information you need to make good decisions about your own care.

Listen to the podcast below:

Disclaimer

When making decisions about medications always speak with your doctor or pharmacist.

Comments

Thank you for sharing this information. I was not aware that anti psychotic meds are sometimes used to treat anxiety. It makes me quite sad that this is the case because anxiety is such treatable condition and there’s a lot of good medication out there, in conjunction with therapy, that can really help! I’m proof of that. Again, thank you for sharing your knowledge with us.

Hi Paul:
I have to write because I happen to be a 60 year old, who was greatly helped by Zyprexa (2.5 mg; low dose;). It worked overnight. I was amazed. This was after six months of trials with anti-depressants and other drugs (such as benzos), which didn’t touch the anxiety. The anxiety was severe (I was in freeze mode 12 hours a day). I was doing meditation, yoga, psycho therapy and, as I mentioned, tired numerous drugs. It was so bad, I attempted suicide back in April. With the Zyprexa, I gained a little weight at first but now am back to my normal appetite. I also, at first, I slept well through the night, and felt drowsy when I woke, but after getting up, felt just fine. To me, this was a miracle drug. By the way, I tried Seroquel a few years ago, and it was awful. I was really skeptical of Zyprexa, because of that, but was running out of options. After all the disappointments, I was astonished that it actually worked. I haven’t noticed any side effects. I’m not at all drowsy during the day. In fact, I am, at least if not more, energetic than normal for me.

I am also on 100 mg of Zoloft, but it did not seem to do much (I started taking it about four months before the Zyprexa). It was really the Zyprexa that seemed to do the trick.

Another thing, I’ve found that if I don’t take it for a few days I don’t have any withdrawal symptoms. On the other hand, if I abruptly discontinued the the Zoloft the withdrawal would be severe.

One more thing, my sister has also suffered from depression and anxiety for most of her life. I urged her to try Zyprexa. She did, and she had the same immediate positive response.

I’ve had patients in the past who’ve had tardive dyskinesia due to psych meds, it doesn’t normally go away when the drugs are stopped, a permanent damage. Children who are on psych meds have to have their cardiac status monitored (That says it may affect the cardiac system) liver enzymes have to be monitored on these drugs as does the cholesterol, etc.

Seroquel is one of many, which is an antipsychotic drug approved to treat schizophrenia and anxiety.

” unless you have schizophrenia, bipolar disorder, or severe depression, taking antipsychotics may be a bad idea.”

I also agree,Paul. How does taking a pill teach the patient how to resolve or minimize their anxiety? Isn’t it a band-aid for the problem? I have read, (I don’t recall where I read it,) that for the majority of anxiety sufferers, medications are not effective. For some they may take the edge off. How much is a persons reflexes off? How much is their mental abilities is impaired?

People at times seem to be under the belief that drug side effects aren’t serious. Did you know that Cipro can cause spontaneous tendon rupture? Yup, the Achilles and shoulder girdles are prime targets. So if you are taking this, and experience pain in any tendon area, stop it and consult your physician immediately. azithromycin can put you in acute renal failure, this happened to my brother.

I realize that anti-psychotics are very dangerous drugs, especially in the doses given for psychosis. But most anxiety sufferers are not given it in those doses. In the very small doses used for anxiety, they work differently. Although I would never take an antipsychotic again (I was briefly on one), I have had much more trouble with benzodiazepines.

I think people should be aware that, although many psych meds seem to work quite well at first, it is possible to build a tolerance to them. For some people this happens rather quickly, especially with benzos. If you are ever unfortunate enough to have this happen, you will have no choice but to either increase your dose or taper off your medication, which is a very painful process for many people. And the sad truth is that most patients and doctors don’t recognize the symptoms of tolerance withdrawal, and end up assuming that the patient has developed new health problems, or that their underlying “disorder” is becoming worse. Many people go for years thinking that they are very ill, when in fact it is their medication that is the culprit.

ALL psych medications can do this, but benzos seem to be some of the worst, not because of their side effects necessarily, but because of the effects of withdrawal. Once the body builds tolerance, you will go into withdrawal even though you are still taking the same amount of medication. I’m going through this now, and have been through it several years ago as well. It’s the worst time of my entire life.

The article below does an excellent job of explaining what is known to date about benzodiazepine withdrawal:

Hey
I am still on the path to quitting my meds after more than 10 years on them. I’m at a low 10mg a day of paxil and sometimes 5mg. In crisis situations, my doctor prescribed me some seroquel. I don’t remember the dose but it’s tiny and I take only half of that to go to sleep.
I don’t like using it. I did use it in the spring once but no more after that.
I didn’t like being prescribed this pill but was afraid of the habit forming aspect of clonazepam, which I had used in the past and which made me more sleepy than calm. Seroquel did temporarily stop my anxiety, long enough to ge some rest and recenter myself. It does make me groggy in the morning, but it goes away.
I’m only saying what I experienced personnally. I used to think I could not be ok without the meds. Now I’m not so sure. I think I can push trhough. Everytime I tried to stop in the past, it came back but I learned that it might have been a withdrawl symptom instead of the anxiety’s revenge.
So it’s bumpy but I’m ok. I exercise, I eat better and I try to keep my mind away from scrutinising things I cannot predict or control.
If taken, antipsychotic drugs should probably be a temporary thing. I’m no doctor. I’m just an anxiety lady.
Hang in there everybody!

I have been taking Paxil close to 10 years now for my anxiety. 3 months ago I was feeling the Paxil was not working for me anymore as I was having a lot of anxiety come back. So I was taken off of that and now I am on Effexor. Seems to be working ok. Back when I was coming off Paxil there was a period of about a month that I had to take xanax every day 4 times a day because the anxiety was getting so intense. I stopped the xanax a few weeks ago as the Effexor took hold. I guess I am lucky as I tent to tolorate these medicines pretty well, minimal side effects, and no problems coming off of the xanax. If I am having bad anxiety and need the xanax it won’t make me tired. I know when I don’t need the xanax anymore as it will begin to make me very tired.

I can certainly respect that some people have experienced relief from taking antidepressants and/or anti-psychotic medications. I was on antidepressants for over 5 years before discontinuing them. When I experienced a severe bout of anxiety I once again turned to antidepressants but did not experience any help from them. I was also put on a low-dose of Risperdal which I was told would help with my racing thoughts. I cannot describe my experience with these drugs as anything less than a horror show. I have made such amazing leaps and bounds in terms of recovery since discontinuing all medication and facing/ accepting my anxiety disorder with the help of programs such as yours. For anyone doubting the harm that pych drugs can do (and yes, I realize even aspirin can be quite harmful), I invite them to watch The Marketing of Madness http://www.youtube.com/watch?v=41_8hZoVKjE
The truth behind all of these drugs is that there is simply no tests that measure if they are working or not. There is not valid test that can even measure so-called chemical imbalances – the very ailment that these drugs are meant to treat. Like I said, I can respect that some people find medication helpful, but I urge everyone considering medication to fully educate themselves first and then please realize that medication is by no means the cure to anxiety (which is a fully treatable condition without the use of medication). I have been very grateful to find a program that has helped me substantially and I invite others to look into the Freedom From Fear Recovery Program. http://freedomfromfeargroup.com/ I don’t get any kickbacks from sharing this. I’m just a fellow sufferer that would like to share what I find helpful and the best part is that there no harmful side effects (not that anxiety can harm you in any way shape or form anyway, but that is a topic for another day).

The past two years. I have woke up after an hour of sleep gasping for air, shaking, chills and blood pressure and heart rate all over the place. Throat feeling tight all the time, have periods where I can not eat. Lost 50 lbs over a year and every doctor tell me that its stress and anxiety which I did not think I had. All my symptoms have changed over the last couple of years. For years have not slept properly. Been experiencing full panic attacks during the day where I dial 911. Finally tried clonazapem that made me dopey all the time. Then abilify which I started feeling anxious and legs felt funny, and was internally feeling no rest. Started Mirtiazapine which I am at the highest dose started sleeping really good. Now after two months all of a sudden started getting panic attacks for no apparent reason. Wondering what is going on. Had 155/100 blood pressure and at times it is 100/70 have palpitations at times and sometimes can be in the low 50 to as high as 140 heart beat. Not sure what to do anymore. It feels like it is constant fear now. Losing weight again. The doctor was throwing everything at me to try to treat it but in some ways it got worse…

I know how scary that can get. Being an anxiety sufferer myself, I know how debilitating one can feel from the anxiety that emerge within even when there were external stressors present. I’m not sure how you spend your day, but even though it is extremely difficult, you should try to get out more and challenge yourself to cope and ignore your anxiety. I have chronic dizziness and often felt afraid that I might faint in public, which leads me to think twice before leaving my home to go shopping or run errands. But the more I fear, the more I wanted to get out to challenge myself. Eventually, the fact that I’ve never passed out crushed my irrational belief. I must admit I’m still a little anxious when I’m out, but at least I don’t let it bother me as much anymore. Sometimes when I feel weak and dizzy, I would start doing aerobic workout at home and afterwards not only did the uneasiness went away, but I felt good and confident knowing the fact that I did not give in to my fear.

Whenever I feel uneasy or uncomfortable but proceed with what I intend to do, I feel I’ve accomplished or scored a win against anxiety. I try not to let anxiety interfere with what I wanted do in my daily life, otherwise I know I will be even more discouraged and distressed knowing that I gave in to anxiety. I also distract myself by focusing on the moment by concentrating on what I’m doing at the moment such as playing with my kids or take a quick walk around the block.

This is all easier said than done, but if you can continue to challenge yourself, you will feel better.

For my dizziness i happened to see an ENT specialist. He diagnosed some tonsillar infection. When i suggested i have been having GAD for the past one year, he immediately put me on Amitryptilline. The first dose knocked me out. Then i learn it is a hypnotic and antipsychotic. I am barely able to do anything. It blocks the calcium and potassium channels and so on and there a host of other functions for this drug. He has given me 30 tabs for one a night for a month. I have decided i cant go on with this. I am stopping it immedately and going back to him tomorrow for a refund of the balance tablets if that is possible. Will stopping after just a single dose cause any nuisance as this is my first time on such a med. If someone is aware pls help.

I feel for other people that are having problems with anziety as I also have.
I don’t take drugs, I am notsaying you cannot get some relief..and goodness knows at times we need it desperately. But, why not try nutritional supplements. You can get a lot of relief from supplements that will never have side affects. Proper diet and and a good night’s sleep are mandatory.
I am a Christian, and I find relief from my belief. I read God’s promises over and over..and I do believe that by reading them over and over they become believable!
One of the best is: ” No weapon formed against me shall prosper”
You might try it too.